10 months post endoscopic brow lift, my left brow has failed due to an extra strong muscle. How common is this?

Although the idea of small incisions is appealing, there are numerous methods of "endoscopic/small incision forehead lifts" claiming adequate results -- and therefore many reasons why they might fail. The most reliable methods of achieving and maintaining long-term significant results from forehead lifts is to identify and excise redundant skin through longer incisions -- either with a coronal lift, hairline lift or mid-forehead lift.

Endoscopic browlift failure is caused by several factors. This can be corrected with the Irregular Trichophytic forehead lift on one or both sides. This was developed 35 years ago and is still my forehead lift of choice for most but not all patients.

endoscopic brow lifts are highly technique dependent and usually for the younger age group with relatively little droop that requires no skin excision. The open approach is time tested, reliable and long lasting. The sensory changes usually resolve in a year.

Although I do perform endoscopic brow lifts, I only do so in select patients. In general I find open brow lifts are much more reliable both in terms of the longevity of the lift was well as the ability to address the forehead muscles. The fact that your surgeon want to correct the one side with an open procedure speaks to that fact. I think that the resulting scar is minimal and negligible if performed appropriately. The open approach allows for better release of the bone along the brow, direct visualization of the muscles and better fixation of the higher brow position. The results last for many years.

Brow lifts by any method can regress. The usual cause of failure is inadequate release of tissues at the orbital rim especially with a subperiosteal dissection as is done with the endoscopic brow lift. I prefer open procedures esoecially if there is a high hairline or there has been haurline elevation from an endoscopic browlift. The trichophytic hairline scar is rrarely detectible. However the open approach always has sensation changes in the scalp that go away with time.